[Question #2869] Okay to move ahead ?

42 months ago
Hello Doctors,

Great service you guys are doing here !

I'll try to be brief as possible
so, my wife and i were not together for some time during which i have done regretful acts, however we're together again which obviously means having normal physical relations without any protection

i do not want to cause her any harm and also need advise if i need to do any kind of follow up

though i did not have sex with anyone else, i've had body to body massages done, received oral sex but did not give and engaged french kissed with tongue (i do have dental issues and cracked lips often) -  all of these were on multiple occasions with different escorts whose status i am not aware of 

any risk of sti including hiv ? may we both move ahead and continue ?

thank you
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
Welcome to the forum. Thanks for your kind words.

STDs are not transmitted by massage or kissing, so no worries there. Oral sex can be considered safe sex as well, with especially low risk for transmission mouth to penis. It's not competely risk free, but the chance of all STDs is a lot lower than for vaginal or anal sex, and it's virtually zero risk for some. Further, most of those infections with appreciable risk cause obvious symptoms:  urethral discharge, often with painful urination, for gonorrrhea and nongonococcal urethritis (NGU); and usually obvious penile sores for herpes. So once it has been 10-14 days since your last such contact, without symptoms, you can be reasonably sure you weren't infected. In addition, the overall STD risk from female escorts is generally believed to be very low. (By "escort", I refer to expensive female sex workers by appointment, as opposed to bar pick-ups, street walkers, etc.) Most such women know the score, have mostly low risk clients (men like you), use condoms for vaginal or anal sex, and typically are tested frequently. So the odds are good your partners had no transmissible STDs.

Having said all that, the risk is low but not zero. If somehow I were in your situation, with no symptoms after 10 days, I would not feel a need for testing and would resume sex with my wife without worry. However, if you would like a somewhat higher level of reassurance, see a physician (preferably someone who understands STDs well, such as a public health clinic, planned parenthood, etc) for exam and testing. The only tests I would recommend are a urine test for gonorrhea and blood tests (after 6 weeks) for syphilis and HIV. However, the latter are so unlikely that I would not wait 6 weeks, and would not wait for the test results, to resume unprotected sex at home.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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42 months ago
Appreciated, thank you

To be clear, the oral sex was long ago of an escort

But the massage including hand jobs and deep french kissing were frequent on multiple occasions and included street pick ups too with status being unknown

as a summary to what you said, the second part of the above holds no value and no need for testing at all ? 
42 months ago
the second part were recent too
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
So your risk is even lower than I thought. Kissing and hand-genital contact are risk free for all STDs, so even though these more recent partners are higher risk, you really needn't worry at all and I don't recommend testing on account of these events. OTOH, you're obviously quite worried, and some people are more reassured by negative tests than by expert opinion alone. If that applies to you, feel free to have a urine test for gonorrhea and chlamydia and blood tests for HIV and syphilis. If you decide to do so, you definitely can expect negative results.

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42 months ago
Thank you and Appreciate the timely response. You all should probably set up a website too since the information is given in a straightforward and simple manner rather the so complicated info given elsewhere which causes so much anxiety . 

Just for re-assurance, had the test for hiv done which was negative - time frame being 8-9 weeks post oral sex exposure but only 2 weeks post the french kissing exposure

However, from what you have mentioned twice above, kissing is risk free for STD so i can conclude now zero risk and resume the unprotected relations?


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
42 months ago
 Exactly right: kissing is no risk, so test timing  after that  really isn't relevant. But I would say the same thing about oral sex as well: also no risk. You really didn't need testing at all.  Certainly you can now safely resume sex with your regular  partner.

 I hope the discussion has been helpful. Best wishes and stay safe. 
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